He was born on 23 September 1933 at Gourishapattom, Trivandrum. His father, R. Parameswaran Pillai, was the Mayor of Trivandrum and his mother Kamalamma was a housewife.[3] He has four sisters. He had his primary education from L.P School, Kunnukuzhi, Thiruvananthapuram. He did pre university degree from MG College and pursued Bachelors in Arts in Hindi from University college, Thiruvananthapuram.[4] He studied and finished post graduation in Hindi from Banaras Hindu University (BHU).[5][6]

He was married to Jayalakshmi till her death in 2014. They have a daughter Uma.[7]

He had expressed all facets of life through his various acting roles. Perhaps his most notable role was in Karyat's Chemmeen, which won the President's Gold Medal. Madhu entered Malayalam cinema at a time when lead roles were dominated by actors like Prem Naseer and Sathyan and created a niche for himself. One of the early films of his career was Bhargavi Nilayam, a suspense movie, followed by Udhyogastha by P. Venu. One of the most common leading co-stars that Madhu worked with, particularly after 1975 was the multi-talented actress Srividya.

He later worked as a producer, director and storywriter. In an acting career spanning four decades, Madhu acted in over 300 films.[9] His first movie as a director is Priya released in 1970, in which he played the role of villain.[10]

Although he was a big star in commercial film, he was generous enough to act in parallel movies. He acted in Adoor Gopalakrishnan's Swayamvaram, P. N. Menon's Olavum Theeravum etc.

Madhu's directorial venture Priya was a trend setter in Malayalam. In this movie he experimented with the main character playing an anti-hero. Madhu later directed about 14 films. He was the owner of once-renowned Uma studio. Madhu produced a movie Mini in 1995, which got National Award.